FEEL WELL • PERIMENOPAUSE

Early signs of perimenopause:
what to notice.

LAST REVIEWED: 2026-10-25 • By the LatelyWell editorial team • How we write & review

Perimenopause can start quietly, with periods that shift a little or sleep that is suddenly lighter. Knowing the common signs helps you make sense of changes and decide when to talk to a doctor. Here is what the NHS lists, and how to describe it clearly.

What perimenopause is

Menopause is when you have not had a period for 12 months. Perimenopause is the time before that, when hormone levels change and your periods start to change. The NHS says menopause usually affects women between 45 and 55, but it can happen earlier, and it affects anyone who has periods.

Perimenopause is different for everyone. The NHS notes that some people have symptoms with a big impact on daily life, work and relationships, while others hardly notice any.

Sign 1: Changes to your periods

The NHS says one of the first signs of perimenopause is usually a change to your periods. They may:

• come more often or less often
• become heavier or lighter
• eventually stop altogether

Keeping a simple record of dates and how heavy each period is makes these changes much easier to describe. Our guide to heavy periods in perimenopause explains when heavier bleeding should be checked.

Sign 2: Hot flushes and night sweats

Hot flushes are when your face, neck and chest suddenly feel very hot or cold. The NHS says they can make you sweat a lot, cause palpitations or anxiety, or make you feel dizzy, and they can last several minutes. At night they are called night sweats. See hot flushes and night sweats for practical steps.

Sign 3: Sleep problems

Not being able to get to sleep or stay asleep is a common symptom, and the NHS notes it may be worse if you also have night sweats. Poor sleep can then make you feel irritable, stressed and anxious. If you wake in the early hours, our guide to waking at 3am may help.

Sign 4: Mood, memory and brain fog

The NHS lists mood swings, low mood or depression, and problems with memory or concentration. These can feel worse when you are tired. Read more in mood changes and anxiety and brain fog.

Other signs the NHS lists

• vaginal dryness, burning, irritation or itching, which can make sex painful
• more urinary tract infections, or symptoms that feel like one
• weight gain, often around the stomach and upper body
• palpitations (a faster, slower or more noticeable heartbeat)
• headaches and migraines that are worse than usual
• muscle aches and joint pains
• hair thinning, and dry or itchy skin
• reduced sex drive
• sensitive teeth, painful gums or other mouth problems

Many of these symptoms can have other causes too, so they are worth discussing rather than assuming.

If you use hormonal contraception

The NHS explains that hormonal contraception can make it harder to tell if you have reached perimenopause, because some types (such as the progestogen-only pill, hormonal coil, implant and injection) can make periods irregular or stop them. You can still get pregnant during perimenopause. The NHS says you still need contraception for 2 years after your final period if you are 40 to 49, and for 1 year if you are 50 or over. Ask a GP which contraception suits you now.

How long symptoms last

The NHS says symptoms usually last 7 to 9 years, sometimes longer, and they can change over time. For example, hot flushes may ease and be replaced by other symptoms such as low mood.

When to see a GP or doctor

The NHS advises contacting your GP if:

• you think you have symptoms of perimenopause and want to know your options
• you have symptoms like a fast heartbeat (palpitations)
• you still have periods but are bleeding more, not less, than before
• you have not had a period for 12 months or more and have any vaginal bleeding

Frequently asked questions

What is usually the first sign of perimenopause?

The NHS says one of the first signs is usually a change to your periods: they may come more or less often, or become heavier or lighter.

At what age does perimenopause start?

The NHS says menopause usually affects women between 45 and 55, but it can happen earlier. Perimenopause is the time leading up to it, so changes often start before your mid-40s to 50s.

Can I still get pregnant during perimenopause?

Yes. The NHS says you still need contraception for 2 years after your last period if you are 40 to 49, and for 1 year if you are 50 or over.

Do I need a blood test to confirm perimenopause?

Not usually if you are over 45. NICE says perimenopause and menopause can generally be diagnosed from symptoms and period pattern. Your doctor may suggest tests if you are younger or to rule out other causes.

Where to find reliable information

If you want to read further, these organisations publish free, evidence-based information for the public:

• UK: the NHS menopause pages, the NICE menopause guideline and the Women's Health Concern factsheets from the British Menopause Society.
• US: The Menopause Society, ACOG and the National Institute on Aging.
• Australia: Jean Hailes for Women's Health and the Australasian Menopause Society.

Guidance differs a little between countries, and treatment names and availability vary, so check what applies where you live and talk to a clinician about your own situation.

The bottom line

Perimenopause often shows up first as changes in your periods, with hot flushes, sleep, mood and many other symptoms possible. Noticing and noting the pattern is the most useful thing you can do, so you can have a clear conversation with a doctor about options.

Educational information only; not medical advice, diagnosis or treatment. Seek professional care for symptoms that are severe, persistent, worsening or concerning.